Health Literacy and Health Outcomes of Adults in the United States: Implications for Providers

The purpose of this paper is to explore health literacy of adults in the United States and review health outcomes as well as provider implications. Limited health literacy is a serious problem in the United States. Approximately 80 million adults in the United States have limited health literacy, which can adversely affect the quality of their health care. Poor health outcomes are associated with being health illiterate. Evidence shows that limited health literacy is associated with more hospitalizations; greater use of emergency care; lower receipt of mammography screening and influenza vaccine; poorer ability to demonstrate taking medications properly; poorer ability to interpret drug labels and health messages; and, among elderly persons, poorer overall health status and higher mortality rates. Health literacy is essential for patients to be able to take control and manage their own health. The benefits of being health literate include greater patient safety, less hospitalizations, a greater ability to care for oneself, and a greater cost savings to the healthcare system. This paper emphasizes “best practices” recommended by the World Health Organization (WHO),1 The American Medical Association (AMA),2 the Institute of Medicine (IOM),3 the Center for Disease Control (CDC),4 and the Joint Commission (JCAHO) 5 When patients, providers and communities work together to understand and improve health literacy a greater quality of life will result. Today’s health care providers are in a position to make an impact on the health illiteracy epidemic and improve the patient’s understanding about their health and outcomes

Departmentalization in the elementary school

Call number: LD2668 .R4 1967 M3

The Effect of Entrepreneurial Marketing on Outcome Goals in SMEs

This study examines how entrepreneurial marketing dimensions (proactiveness, opportunity focused, leveraging, innovativeness, risk taking, value creation, and customer intensity) are related to qualitative and quantitative outcome measures for the SME and the entrepreneur (including company success, customer success, financial success, satisfaction with return goals, satisfaction with growth goals, excellence, and the entrepreneur’s standard of living). Using factor analysis, three success outcome variables (financial, customer, and strong company success) emerged together. A separate factor analysis identified satisfactory growth and return goals. Stepwise regression revealed entrepreneurial marketing impacts outcome variables, particularly value creation. Implications for entrepreneurs and areas for research are included

Violin Master Class with Marilyn McDonald

Marilyn McDonald, a founding member of the Smithson Quartet and the Castle Trio, currently plays in the Axelrod Quartet in residence at the Smithsonian Institution and so named in honor of the donor of the decorated Stradivarius instruments on which the quartet performs.https://digitalcommons.usu.edu/music_programs/1097/thumbnail.jp

Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder

<p>Abstract</p> <p>Background</p> <p>Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived.</p> <p>Methods/design</p> <p>Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis incuding the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study.</p> <p>Discussion</p> <p>This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and implementation.</p> <p>Trial registration</p> <p>Clinical trials.gov identifier NCT01047124</p

Dust Production and Mass Loss in the Galactic Globular Cluster NGC 362

We investigate dust production and stellar mass loss in the Galactic globular cluster NGC 362. Due to its close proximity to the Small Magellanic Cloud (SMC), NGC 362 was imaged with the IRAC and MIPS cameras onboard the Spitzer Space Telescope as part of the Surveying the Agents of Galaxy Evolution (SAGE-SMC) Spitzer Legacy program. We detect several cluster members near the tip of the Red Giant Branch that exhibit infrared excesses indicative of circumstellar dust and find that dust is not present in measurable quantities in stars below the tip of the Red Giant Branch. We modeled the spectral energy distribution (SED) of the stars with the strongest IR excess and find a total cluster dust mass-loss rate of 3.0(+2.0/-1.2) x 10^-9 solar masses per year, corresponding to a gas mass-loss rate of 8.6(+5.6/-3.4) x 10^-6 solar masses per year, assuming [Fe/H] = -1.16. This mass loss is in addition to any dust-less mass loss that is certainly occurring within the cluster. The two most extreme stars, variables V2 and V16, contribute up to 45% of the total cluster dust-traced mass loss. The SEDs of the more moderate stars indicate the presence of silicate dust, as expected for low-mass, low-metallicity stars. Surprisingly, the SED shapes of the stars with the strongest mass-loss rates appear to require the presence of amorphous carbon dust, possibly in combination with silicate dust, despite their oxygen-rich nature. These results corroborate our previous findings in omega Centauri.Comment: 13 pages, 11 figures. Accepted to Ap

Surveying the Agents of Galaxy Evolution in the Tidally-Stripped, Low Metallicity Small Magellanic Cloud (SAGE-SMC) II. Cool Evolved Stars

We investigate the infrared (IR) properties of cool, evolved stars in the Small Magellanic Cloud (SMC), including the red giant branch (RGB) stars and the dust-producing red supergiant (RSG) and asymptotic giant branch (AGB) stars using observations from the Spitzer Space Telescope Legacy program entitled: "Surveying the Agents of Galaxy Evolution in the Tidally-stripped, Low Metallicity SMC", or SAGE-SMC. The survey includes, for the first time, full spatial coverage of the SMC bar, wing, and tail regions at infrared (IR) wavelengths (3.6 - 160 microns). We identify evolved stars using a combination of near-IR and mid-IR photometry and point out a new feature in the mid-IR color-magnitude diagram that may be due to particularly dusty O-rich AGB stars. We find that the RSG and AGB stars each contribute ~20% of the global SMC flux (extended + point-source) at 3.6 microns, which emphasizes the importance of both stellar types to the integrated flux of distant metal-poor galaxies. The equivalent SAGE survey of the higher-metallicity Large Magellanic Cloud (SAGE-LMC) allows us to explore the influence of metallicity on dust production. We find that the SMC RSG stars are less likely to produce a large amount of dust (as indicated by the [3.6]-[8] color). There is a higher fraction of carbon-rich stars in the SMC, and these stars appear to able to reach colors as red as their LMC counterparts, indicating that C-rich dust forms efficiently in both galaxies. A preliminary estimate of the dust production in AGB and RSG stars reveals that the extreme C-rich AGB stars dominate the dust input in both galaxies, and that the O-rich stars may play a larger role in the LMC than in the SMC.Comment: Accepted for publication in AJ. 25 pages, 36 figures, Table 4 will be available electronically from A